scholarly journals How I treat Burkitt lymphoma in adults

Blood ◽  
2014 ◽  
Vol 124 (19) ◽  
pp. 2913-2920 ◽  
Author(s):  
Caron Jacobson ◽  
Ann LaCasce
Keyword(s):  
Burkitt Lymphoma ◽  
Older Patients ◽  
Infectious Complications ◽  
Chromosome 8 ◽  
Treatment Intensity ◽  
Tumor Lysis ◽  
Non Hodgkin Lymphoma ◽  
Prevention And Treatment ◽  
Central Nervous System Prophylaxis ◽  
Relapsed Disease

Abstract Burkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma that is almost uniformly associated with translocations involving the gene for MYC on chromosome 8. The 3 subtypes of BL, endemic, sporadic, and immunodeficiency-associated, differ from epidemiologic and clinical perspectives but may be genetically similar. Prompt administration of multiagent immunochemotherapy regimens is associated with favorable outcomes for the majority of patients. Survival is inferior in older patients, likely reflecting increased therapy-related toxicity, possibly resulting in decreased treatment intensity. Central nervous system prophylaxis, tumor lysis prevention and treatment, and management of infectious complications from myelosuppressive regimens are critical. Prognosis of refractory or relapsed disease is poor and patients are best treated on clinical trials when available.

scholarly journals Increased Risk of Infectious Complications in Older Patients With Indolent Non-Hodgkin Lymphoma Exposed to Bendamustine

2018 ◽  
Vol 68 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Monica Fung ◽  
Eric Jacobsen ◽  
Arnold Freedman ◽  
Daniel Prestes ◽  
Dimitrios Farmakiotis ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Older Patients ◽  
Infectious Complications ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk

scholarly journals The treatment of Burkitt lymphoma in adults

Blood ◽  
2020 ◽  
Author(s):  
Jennifer L. Crombie ◽  
Ann S. LaCasce
Keyword(s):  
Burkitt Lymphoma ◽  
Randomized Trials ◽  
Treatment Options ◽  
Unmet Need ◽  
Cns Involvement ◽  
Non Hodgkin Lymphoma ◽  
Genomic Landscape ◽  
Relapsed Disease ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Burkitt lymphoma (BL) is a highly aggressive, B-cell, non-Hodgkin lymphoma (NHL) categorized into endemic, sporadic and immunodeficiency-associated subtypes. BL has distinct pathologic and clinical features, characterized by rapidly progressive tumors with high rates of extranodal involvement. Next generation sequencing (NGS) analyses have further characterized the genomic landscape of BL and our understanding of disease pathogenesis, though these findings have yet to influence treatment. Although the majority of patients are cured with intensive combination chemotherapy, given the paucity of randomized trials, optimal therapy has not been defined. Furthermore, treatment for elderly patients, patients with central nervous system (CNS) involvement, or those with relapsed disease, remains an unmet need. In this review, we highlight the clinical, pathologic, and genomic features, as well as standard and emerging treatment options for adult patients with BL.

scholarly journals Blood Pressure Targets for Older Patients—Do Advanced Age and Frailty Really Not Matter?

2020 ◽  
Vol 23 (2) ◽  
pp. 205-209
Author(s):  
Amanda Giffin ◽  
Kenneth M. Madden ◽  
David B. Hogan
Keyword(s):  
Blood Pressure ◽  
Risk Assessment ◽  
Older Patients ◽  
Intensive Therapy ◽  
Advanced Age ◽  
Blood Pressure Targets ◽  
Prevention And Treatment ◽  
Treatment Of Hypertension ◽  
The Relationship

In 2017, Hypertension Canada removed advanced age and frailty as considerations for caution when deciding on intensive therapy in their guidelines for the diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Dementia is not mentioned. In this commentary, we review why advanced age and frailty were removed, and examine what is currently known about the relationship between hypertension and both incident and prevalent dementia. We make the case that the presence of frailty (especially when severe) and dementia should be considered when deciding on intensive therapy in future iterations of Hypertension Canada guidelines.

scholarly journals Infectious Complications in Aggressive B Cell Non-Hodgkin Lymphoma after CD-19 Chimeric Antigen Receptor T Cell Therapy

2020 ◽  
Vol 26 (3) ◽  
pp. S326 ◽  
Author(s):  
Kitsada Wudhikarn ◽  
Martina Pennisi ◽  
Martha Garcia Recio ◽  
Molly A. Maloy ◽  
Gunjan L. Shah ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Therapy ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Chimeric Antigen Receptor ◽  
Antigen Receptor ◽  
Infectious Complications ◽  
T Cell Therapy ◽  
Non Hodgkin Lymphoma

scholarly journals Burkitt Lymphoma of the Duodenum: An Uncommon Phenomenon

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Fahad Malik ◽  
Manuel Gonzalez ◽  
Wahib Zafar
Keyword(s):  
Gastrointestinal Tract ◽  
Burkitt Lymphoma ◽  
Gastrointestinal Symptoms ◽  
Immunocompromised Patients ◽  
Limited Data ◽  
Gi Tract ◽  
Non Hodgkin Lymphoma ◽  
Abdominal Symptoms ◽  
Improved Outcomes ◽  
Early Endoscopy

Burkitt lymphoma is an aggressively growing tumor commonly found in African children, involving the jaw and facial bones. Most non-Hodgkin lymphoma tumors involve extra nodal sites like the nervous system and gastrointestinal tract. A rare variant of this type of lymphoma is found in immunocompromised patients specifically in the gastrointestinal tract with accompanying gastrointestinal symptoms. Burkitt lymphoma is a malignancy that has commonly presented in GI tract but rarely in the duodenum. This clinical variant can commonly involve stomach, ileum, and cecum. However, there is very limited data available regarding the duodenal growth of this tumor. Duodenal involvement of Burkitt lymphoma is extremely rare and accounts for < 1% of all lymphomas. We present a case report of an older patient with a duodenal Burkitt lymphoma diagnosed by biopsy. A high suspicion should be present while treating immunocompromised patients with chronic abdominal symptoms especially with complications such as bleeding or occult positive testing. Early endoscopy intervention with biopsy can help identity and treat these conditions with improved outcomes for the patients.

scholarly journals Cotargeting BCL-2 and MCL-1 in high-risk B-ALL

2020 ◽  
Vol 4 (12) ◽  
pp. 2762-2767
Author(s):  
Donia M. Moujalled ◽  
Diane T. Hanna ◽  
Soroor Hediyeh-zadeh ◽  
Giovanna Pomilio ◽  
Lauren Brown ◽  
...  
Keyword(s):  
High Risk ◽  
Kinase Inhibitors ◽  
Therapeutic Option ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Tumor Burden ◽  
Tumor Lysis ◽  
Relapsed Disease ◽  
Bh3 Mimetic

Abstract Improving survival outcomes in adult B-cell acute lymphoblastic leukemia (B-ALL) remains a clinical challenge. Relapsed disease has a poor prognosis despite the use of tyrosine kinase inhibitors (TKIs) for Philadelphia chromosome positive (Ph+ ALL) cases and immunotherapeutic approaches, including blinatumomab and chimeric antigen receptor T cells. Targeting aberrant cell survival pathways with selective small molecule BH3-mimetic inhibitors of BCL-2 (venetoclax, S55746), BCL-XL (A1331852), or MCL1 (S63845) is an emerging therapeutic option. We report that combined targeting of BCL-2 and MCL1 is synergistic in B-ALL in vitro. The combination demonstrated greater efficacy than standard chemotherapeutics and TKIs in primary samples from adult B-ALL with Ph+ ALL, Ph-like ALL, and other B-ALL. Moreover, combined BCL-2 or MCL1 inhibition with dasatinib showed potent killing in primary Ph+ B-ALL cases, but the BH3-mimetic combination appeared superior in vitro in a variety of Ph-like ALL samples. In PDX models, combined BCL-2 and MCL1 targeting eradicated ALL from Ph− and Ph+ B-ALL cases, although fatal tumor lysis was observed in some instances of high tumor burden. We conclude that a dual BH3-mimetic approach is highly effective in diverse models of high-risk human B-ALL and warrants assessment in clinical trials that incorporate tumor lysis precautions.

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